Help for Common Caregiving Conflicts

Caregiving for someone you love can be emotionally charged and sometimes frustrating. When you add clashing personalities to the mix, conflicts are almost inevitable. There is no magic solution: How you respond will depend on the specifics of the situation and your own resources. But some general conflict diffusers often prove helpful, such as involving a neutral party, putting plans and agreements in writing, discussing facts not feelings (in some cases), and, most important, keeping your loved one’s best interests in the foreground.

When siblings disagree

Adult siblings caring for parents can clash over what kind of care is best, how to pay for care and who will perform the care. These conflicts are often exacerbated by old family resentments, jealousies, power struggles and trust issues. (“Mom always loved you best!”) It’s difficult, but crucial, to keep these disruptive emotions from interfering with your parents’ well-being.

Quick Tips:

Establish clear roles. One sibling may feel resentment over bearing the bulk of the caregiving burden — or may be reluctant to relinquish control, causing resentment among those left out. It helps to have an initial planning meeting for distributing tasks, and to communicate clearly and often.

Involve a mediator. An impartial presence — depending on the nature of the dispute, it may be a respected relative or physician — can take tensions down several notches. Families sometimes bring a professional mediator onboard to resolve serious conflicts.

Hire a care manager. Also called a geriatric care navigator, a care manager can serve as another objective voice while guiding you toward the best health care resources in your area. You may need only a brief consultation to help your family come to consensus on a care plan.

Loved one refuses care

The friend or family member you’re caring for may resist having a beneficial medical procedure, taking prescribed medications or hiring in-home help. If you are convinced that the disputed care is in your loved one’s best interest, certain approaches can help them see your point of view. It might help, for example, to include their physician in the discussion; or if the issue has become a power struggle between you and your loved one, it might be best to step aside completely.

Quick Tips:

Plan a good time for discussion. You’ll want to bring the subject up when you are both feeling good and relaxed. Anything that can help everyone involved remain calm will be helpful.

Focus on the positives. Point out that the care will make your job as a caregiver easier (if that’s the case). If they are resistant to hiring in-home help, you might stress that the assistance will allow them to live at home safely and longer. Include them in the interview process if possible.

Don’t force it. If your loved one is healthy enough to make their own decisions, they have the right to refuse care. If they’re not cognitively able to do so and you have power of attorney, however, you are legally responsible for deciding what’s in their best interest.

Driving risks

Impaired driving isn’t only a danger to the driver; it can — and does — injure or kill others. Some people are aware of their own compromised skills and willingly hang up their keys; others deny dysfunction and remain deeply reluctant to give up the independence that driving represents. A test may be all the evidence you need to convince them that your concerns are valid.

Quick Tips:

Stay alert to signs of impairment. It’s important to observe your loved one behind the wheel and note red-flag behavior, including hitting curbs, poor judgment making left-hand turns and changing lanes, and driving at inappropriate speeds.

Discuss your concerns calmly. Keeping a lid on your frustration as best you can, tell your loved one that they may be right: Maybe they’re perfectly fit to drive — but there’s no harm in getting tested, or at least taking an online self-evaluation. Be empathetic about the loss of freedom they fear.

Involve a professional. Physicians can perform an Assessment of Driving Related Skills (ADReS) to identify dangerous cognitive impairment or problems with vision or motor function. A driver rehabilitation specialist or occupational therapist can test for risky behavior.

Look up your state’s driving laws for seniors. Some are far stricter than others, requiring frequent vision tests for older drivers or, as is the case in Wisconsin, maintaining the right to suspend a license if a doctor reports that a driver is high-risk.

When money’s the problem

Money disputes are at the heart of so many families’ caregiving conflicts, and they can get ugly. Out-of-town family members might be suspicious that the live-in family caregiver is taking financial advantage of their loved one, or siblings may squabble over how to pay for a parent’s care. Such drama can be avoided if the person being cared for has clearly stated health care preferences and legal paperwork is in order. Otherwise, resolution sometimes requires the involvement of a mediator or, in the worst cases, the courts.

Quick Tips:

Address questions about how much is spent on care. Sometimes one family member accuses the primary caregiver of spending too much on their loved one’s care. If you are that primary caregiver, you might ask the doubter to take over your role for a few days to better understand why services are needed.

Resolve disagreements over who should pay for care. If your loved one doesn’t have funds to pay for their own care beyond what government programs cover, your family members may dispute who should contribute: the wealthiest? The least helpful with caregiving? Everyone equally? A mediator can be invaluable in helping a family work through these questions.

Protect against financial abuse. It’s a sad fact that most elder abuse occurs at the hands of a family member. If you suspect wrongdoing, ask your loved one if you can review bank statements. If they are incapacitated and the suspected perpetrator has power of attorney and remains uncooperative, you may need to take the issue to court.

Emotional Stress

As a family caregiver, it’s easy to forget about your own needs — which is why caregivers are more likely to report high stress levels, depression and other health problems. It’s imperative that you find some form of support and set aside time to address your own health issues, both mental and physical. And try not to feel guilty: You can’t care well for others if you don’t care for yourself.

Quick Tips:

Join a support group. Even when you love the person you’re caring for, you may also feel darker emotions such as anger, resentment and grief. Many caregivers find great relief in sharing their feelings with other caregivers who’ve felt much the same way.

Address depression. If you feel sadness and anxiety that lasts for weeks at a time, are sleeping too little or too much or have other symptoms of depression, see a mental health professional. Depression is treatable; you needn’t just suffer through it.

Take time out. Don’t neglect exercise, sleep, healthy eating and activities that bring you pleasure. Maybe find a relative who can fill in to allow you a vacation, or even a quiet staycation. Otherwise look into options for respite care in your area.

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